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From the Department of Neurology (Drs. Saint-Hilaire, Feldman, and Myers, and J. Wilk, J. Volcjak, N. Maher, and J. Maher), Boston University School of Medicine, MA; Department of Neurology (Drs. Golbe, Mark, and Lazzarini), University of Medicine and Dentistry of New Jersey–Robert Wood Johnson Medical School, New Brunswick; Department of Neurology (Drs. Currie and Wooten), University of Virginia Health System, Charlottesville; Division of Neurology, Department of Medicine (Dr. Guttman), University of Toronto, Ontario, Canada; Department of Neurology (Dr. Lew and S. Schuman), University of Southern California, Los Angeles; Departments of Clinical Neurosciences and Medical Genetics (Drs. Suchowersky and Lafontaine, and N. Labelle), University of Calgary, Alberta, Canada; Department of Neurology (Drs. Vieregge and Klein), Medical University of Lübeck, Germany; Department of Neurology (Dr. Pramstaller), General Regional Hospital Bolzano, Italy; Department of Neurology (Drs. Hubble and Reider), Ohio State University, Columbus; Department of Neurology (Dr. Growdon), Massachusetts General Hospital, Harvard Medical School, Boston; Department of Neurology (Dr. Watts), Emory University, Atlanta, GA; Departments of Neurology and Neuroscience (Drs. Montgomery and Baker), Cleveland Clinic Foundation, OH; Department of Neurology (Dr. Singer), University of Miami, FL; Department of Neurology (Dr. Stacy), Barrow Clinic, Phoenix, AZ.
Address correspondence and reprint requests to Dr. Richard H. Myers, Department of Neurology, 715 Albany Street, B-603, Boston University School of Medicine, Boston, MA 02118; e-mail: rmyers{at}bu.edu
Objective: To examine patterns of familial aggregation and factors influencing onset age in a sample of siblings with PD.
Methods: Sibling pairs (n = 203) with PD were collected as part of the GenePD study. Standardized family history, medical history, and risk factor data were collected and analyzed.
Results: The mean age at onset was 61.4 years and did not differ according to sex, exposure to coffee, alcohol, or pesticides. Head trauma was associated with younger onset (p = 0.03) and multivitamin use with later onset (p = 0.007). Age at onset correlation between sibling pairs was significant (r = 0.56, p = 0.001) and was larger than the correlation in year of onset (r = 0.29). The mean difference in onset age between siblings was 8.7 years (range, 0 to 30 years). Female sex was associated with increased frequency of relatives with PD. The frequency of affected parents (7.0%) and siblings (5.1%) was increased when compared with frequency in spouses (2.0%).
Conclusions: The greater similarity for age at onset than for year of onset in sibling pairs with PD, together with increased risk for biological relatives over spouses of cases, supports a genetic component for PD. Risk to siblings in this series is increased over that seen in random series of PD cases; however, patients in this sample have similar ages at onset and sex distribution as seen for PD generally. These analyses suggest that factors influencing penetrance are critical to the understanding of this disease.
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